1
|
Attard Montalto A, Mifsud S, Deguara J, Attard Cortis P. Perceived authority gradients among anaesthetic teams in Malta. J Perioper Pract 2024:17504589241232509. [PMID: 38706307 DOI: 10.1177/17504589241232509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Over the decades, cases like those of Elaine Bromiley, who passed away after a 'cannot intubate, cannot ventilate' scenario, have prompted deeper analyses of team dynamics and authority gradients. It is thought that a steep authority gradient may have impeded lifesaving communication between members of the anaesthetic team, leading to her death. Using an online questionnaire, we carried out a cross-sectional observational study exploring the perceived authority gradients within anaesthetic teams in the main operating theatres at Mater Dei Hospital, Malta. Nurses were found to experience a steeper authority gradient than anaesthetists. They were less comfortable making suggestions too and also felt like the suggestions they made were less listened to by lead anaesthetists. To a lesser extent, females also experienced a steeper authority gradient. Increasing age and grade were associated with a flatter authority gradient. Further research needs to be carried out to identify the underlying reasons behind the steeper perceived authority gradient affecting nurses. Interventions are being planned to attempt to decrease the perceived authority gradient.
Collapse
Affiliation(s)
- Andrew Attard Montalto
- Department of Anaesthesia, Intensive Care & Pain Medicine, Mater Dei Hospital, Msida, Malta
| | - Stephanie Mifsud
- Department of Anaesthesia, Intensive Care & Pain Medicine, Mater Dei Hospital, Msida, Malta
| | - Justin Deguara
- Department of Anaesthesia, Intensive Care & Pain Medicine, Mater Dei Hospital, Msida, Malta
- Department of Nursing, Mater Dei Hospital, Msida, Malta
| | - Petramay Attard Cortis
- Department of Anaesthesia, Intensive Care & Pain Medicine, Mater Dei Hospital, Msida, Malta
- Department of Nursing, Mater Dei Hospital, Msida, Malta
| |
Collapse
|
2
|
Camargo A, Radmard M, Dabiri M, Carson KA, Hsu L, Yousem DM. Discrimination faced by radiology residents: an analysis of experiences and mitigation strategies. Curr Probl Diagn Radiol 2024:S0363-0188(24)00087-2. [PMID: 38714392 DOI: 10.1067/j.cpradiol.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 05/02/2024] [Indexed: 05/09/2024]
Abstract
RATIONALE AND OBJECTIVES Literature shows that discrimination has been pervasive in the field of medicine. The aim of this study was to collect experiences related to discrimination among US radiology residents, including type and source, as well as the residents' perception on lectures about discrimination and harassment. We also explored the barriers to reporting, and suggested strategies to overcome them. MATERIAL AND METHODS Following Institutional Review Board (IRB) approval, an online survey was sent to program directors and coordinators across the US, who were asked to forward the link to their radiology residents. A reminder email was sent over a period of 4 months. The participants were reassured the survey was confidential and anonymous. RESULTS Among the respondents, the most reported types of discrimination were based in gender, race and nationality, the majority of which not being reported. The most common perpetrators were attending radiologists, co-residents, technologists, and patients. The main barriers for reporting were fear of retaliation, confidentiality concerns, and skepticism about a positive outcome. CONCLUSION Our study examines some experiences of discrimination shared by residents during their training, with gender and race being the most common causes. This sheds light into a hidden and unspoken issue and highlights the need for more active discussions in radiology on microaggressions and implicit bias. Our data can guide future studies as well as residency programs to build effective strategies to address discrimination, aiming for sustainable changes.
Collapse
Affiliation(s)
- Aline Camargo
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA, 30322 USA.
| | - Mahla Radmard
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 1800 Orleans Street, Baltimore, MD, 21287 USA
| | - Mona Dabiri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 1800 Orleans Street, Baltimore, MD, 21287 USA
| | - Kathryn A Carson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205 USA
| | - Liangge Hsu
- Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, 75 Francis Street, Boston, MA, 02115 USA
| | - David M Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 1800 Orleans Street, Baltimore, MD, 21287 USA
| |
Collapse
|
3
|
Khounsarian F, Abu-Omar A, Emara A, Marinescu D, Yong-Hing CJ, Ali IT, Khosa F. A trend, analysis, and solution on women's representation in diagnostic radiology in North America: a narrative review. Clin Imaging 2024; 109:110135. [PMID: 38547670 DOI: 10.1016/j.clinimag.2024.110135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 04/17/2024]
Abstract
Despite the demonstrated benefits of gender diversity in medicine, women in Radiology in North America are still underrepresented. We reviewed the literature to highlight the current status of women in Radiology in North America, identify the underlying causes of the gender gap, and provide potential strategies to close this gap. We conducted a narrative literature review using the terms ("Gender Disparity" OR "Gender Inequality") AND ("Radiology Department" OR "Radiology Residency"), searching data from April 2000 to April 2022 in Ovid Medline, Embase, PubMed, and Scopus. Our results indicate that Radiology in North America lacks gender diversity in its subspecialties, academic leadership, and research productivity, which the COVID-19 pandemic has further exacerbated. Challenges stemming from a dearth of women role models, limited preclinical contact, and a high rate of burnout contribute to the current gender inequality. Several complementary and supplementary steps can enhance gender diversity in Radiology. These include increasing education and exposure to Radiology at earlier stages and optimizing mentorship opportunities to attract a more diverse pool of talent to the discipline. In addition, supporting resident parents and enhancing the residency program's culture can decrease the rate of burnout and encourage women to pursue careers and leadership positions in Radiology.
Collapse
Affiliation(s)
| | - Ahmad Abu-Omar
- Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Aida Emara
- Health Education England North East, United Kingdom
| | | | - Charlotte J Yong-Hing
- Clinical Associate Professor, Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Ismail Tawakol Ali
- Clinical Associate Professor, Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Faisal Khosa
- Clinical Associate Professor, Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| |
Collapse
|
4
|
Yi SY, Ali NS, Lee KS, Ross AB. Prevalence and Impact of Workplace Sexual Harassment Experienced by Medical Sonographers. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2024; 43:307-314. [PMID: 37853981 DOI: 10.1002/jum.16361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/05/2023] [Accepted: 10/03/2023] [Indexed: 10/20/2023]
Abstract
OBJECTIVE To assess the prevalence and impact of sexual harassment among a nationwide sample of medical sonographers. METHODS A survey was distributed anonymously to a convenience sample of medical sonographers via email contacts and sonographer-specific social media pages. Data were analyzed to determine respondent demographics, the prevalence of sexual harassment in the last 2 years, the type and severity of harassment experienced, demographics of perpetrators, personal and institutional responses to such experiences, and the impact of sexual harassment on sonographer physical and mental health and job satisfaction. RESULTS Of the 220 sonographers (83% female) most (45%) were between 18 and 34 years and identified as white (81%). A total of 192 (87%) reported experiencing at least 1 incident of harassment within the last 2 years. Female respondents experienced higher harassment rates (76%) compared to males (50%, P = .02). The most common forms of harassment were verbal, including suggestive or sexist jokes (69%) and offensive sexist remarks (61%). Perpetrators were predominantly male (78%) and most commonly patients (89%) or their friends/family members (46%). The majority of respondents either ignored the harassing behavior (70%) or treated it like a joke (50%), with only a minority (12%) officially reporting incidents. Of those who reported, 44% were unsatisfied with their institution's response. Among respondents, 34% reported negative impacts of workplace sexual harassment, such as anxiety, depression, sleep loss, or adverse workplace consequences. DISCUSSION Workplace sexual harassment is a common occurrence for sonographers and often leads to negative health and career outcomes. Further institutional policies to prevent harassment and mitigate its effects are needed.
Collapse
Affiliation(s)
- Sue Y Yi
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Naiim S Ali
- Department of Radiology, University of Vermont Medical Center, Burlington, Vermont, United States
| | - Kenneth S Lee
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| | - Andrew B Ross
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, United States
| |
Collapse
|
5
|
Busch IM, Rimondini M, Scott SD, Moretti F, Cecchin D, Wu AW, Giraudo C. Workplace violence in radiology: results of a systematic review. Occup Med (Lond) 2023; 73:541-546. [PMID: 38072465 DOI: 10.1093/occmed/kqad123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND Workplace violence (WPV) is a growing issue in health care with far-reaching consequences for health workers' physical and psychological well-being. While some medical specialities like emergency medicine have always been considered at higher risk for WPV, several studies have also reported its occurrence in radiology. AIMS This systematic review aimed to comprehensively synthesize the types of WPV in radiology, its psychological impact, and the underlying risk and protective factors. METHODS We searched five electronic databases (PubMed, Web of Science Core Collection, Scopus, PsycINFO and CINAHL) and additional literature, including grey literature, and established weekly search alerts. Two reviewers independently conducted all methodological steps, involving a third reviewer in case of disagreement. RESULTS Of the 12 205 retrieved records, 103 full-text articles were evaluated, and 15 studies were included. Across studies, verbal aggression, sexual harassment (mostly against women) and physical violence were experienced by up to 100%, 85% and 46% of health workers, respectively. Perpetrators were patients and patients' caregivers, followed by co-workers. Victims suffered from various psychological symptoms, such as anxiety (22%-54%), fear (6%-39%), depression (32%) and repeated disturbing memories (21%). Risk factors included female gender, understaffing, worker inexperience, poor communication and lengthy waiting times. Social support and security personnel presence were among the identified protective factors. CONCLUSIONS Health workers are at high risk of experiencing WPV in the radiological setting, with a strong psychological impact. Radiological departments should create a safe healthcare environment that actively manages the identified risk factors and offers psychological support to affected workers.
Collapse
Affiliation(s)
- I M Busch
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - M Rimondini
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - S D Scott
- University of Missouri Health Care and Sinclair School of Nursing, Columbia, MO 65212, USA
| | - F Moretti
- Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37134 Verona, Italy
| | - D Cecchin
- Department of Medicine, University of Padova, 35121 Padova, Italy
| | - A W Wu
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - C Giraudo
- Department of Medicine, University of Padova, 35121 Padova, Italy
| |
Collapse
|
6
|
JUNGES FORUM – Geschlechtergleichheit und sexuelle Übergriffe in der Radiologie. ROFO-FORTSCHR RONTG 2022. [DOI: 10.1055/a-1855-5817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
|
7
|
Pandrowala S, Patkar S, Nair D, Maheshwari A, Pramesh CS, Puri A. Gender discrimination in surgical oncology: An in-house appraisal. Front Surg 2022; 9:939010. [PMID: 35903261 PMCID: PMC9314771 DOI: 10.3389/fsurg.2022.939010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/27/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction Gender discrimination (GD) though rarely blatant, may present indirectly within a surgical department in the form of subtle inequities, differing standards, and bias. GD encompasses a wide spectrum including academic development, surgical opportunities and sexual harassment. Methods We conducted an online survey to analyse the perceived incidence of GD in the surgical oncology department at a tertiary care cancer centre in India. The questionnaire consisted of 15 questions and was mailed to the entire department including trainees and faculty. Anonymity was maintained while collecting the data only of the participants' gender and whether they were faculty or trainee. Collated responses were analysed using proportions. Results The questionnaire was sent out to 200 recipients of whom 56% (112/200) responded via an online survey. Respondents included 84% of faculty (42/50) and 46.6% of trainees (70/150). GD was perceived by 28% of female trainees (7/25) as compared to 6.6% of male trainees (3/45), whereas amongst faculty, GD was perceived by 26.6% of female faculty (4/15) compared to 14.8% of male faculty (3/27). Approximately 13% of our trainees and 12% of our faculty mentioned that GD affected their professional performance or mental well-being. GD was experienced in terms of work experience and opportunities by a majority of trainees (13%) and faculty (9.5%). There was a significant lack of awareness about recourse to an institutional grievance committee by trainees (47%) compared to faculty (14%). About 7% of trainees and 12% of faculty acknowledged that they may have been responsible for intentional/unintentional GD. Conclusion Gender discrimination can present in subtle or overt fashion in surgical departments and requires active sustained efforts to allow both genders to feel equally empowered. Establishing a system to objectively evaluate gender equity while avoiding stereotyping for certain roles can help minimize GD.
Collapse
Affiliation(s)
- Saneya Pandrowala
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Shraddha Patkar
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
- Correspondence: Shraddha Patkar
| | - Deepa Nair
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Amita Maheshwari
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - C. S. Pramesh
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| | - Ajay Puri
- Department of Surgical Oncology, Tata Memorial Centre and Homi Bhabha National Institute, Mumbai, India
| |
Collapse
|
8
|
Meltzer CC. Gender Discrimination and Harassment in Radiology. Acad Radiol 2022; 29:426-427. [PMID: 34742649 DOI: 10.1016/j.acra.2021.09.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 09/09/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Carolyn C Meltzer
- Emory University Hospital, Radiology and Imaging Sciences, Suite D-112, 1364 Clifton Road NE, United States.
| |
Collapse
|
9
|
Maldjian T, Yee J. The case for more women in radiology and radiation oncology. Clin Imaging 2022; 85:123-124. [DOI: 10.1016/j.clinimag.2022.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/03/2022]
|
10
|
Hehman JA, Salmon CA, Pulford A, Ramirez E, Jonason PK. Who perceives sexual harassment? Sex differences and the impact of mate value, sex of perpetrator, and sex of target. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022. [DOI: 10.1016/j.paid.2021.111288] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
11
|
Ayyala RS, Coley BD. Promoting gender equity and inclusion through allyship. Pediatr Radiol 2022; 52:1202-1206. [PMID: 35316337 PMCID: PMC8938576 DOI: 10.1007/s00247-022-05345-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 02/07/2022] [Accepted: 02/28/2022] [Indexed: 11/23/2022]
Affiliation(s)
- Rama S. Ayyala
- grid.239573.90000 0000 9025 8099Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnett Ave., Cincinnati, OH 45229 USA
| | - Brian D. Coley
- grid.239573.90000 0000 9025 8099Department of Radiology, Cincinnati Children’s Hospital Medical Center, 3333 Burnett Ave., Cincinnati, OH 45229 USA
| |
Collapse
|
12
|
Pitot MA, White MA, Edney E, Mogensen MA, Solberg A, Kattapuram T, Sinha C, Kadom N. You Too? Female Radiologists' Narratives on Discrimination and Harassment. J Am Coll Radiol 2021; 19:288-303. [PMID: 34822789 DOI: 10.1016/j.jacr.2021.09.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/23/2021] [Accepted: 09/25/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is a paucity of examples for gender discrimination and sexual harassment in radiology. This lack of knowledge can limit radiologists' ability to relate to this topic, acknowledge its importance and impact, and take actions toward improvement. MATERIALS AND METHODS We conducted a qualitative analysis using the model of thematic analysis developed by Braun and Clarke of narrative responses to a survey on the topic of #MeToo, which was distributed to a social media group of female radiologists. RESULTS In all, 575 anonymous survey responses from 3,265 social media group members were analyzed. Among these responses, the study team identified important themes with examples, including Victims and Perpetrators, Acts of Gender Discrimination, Inequalities, Sexual Harassment and Assault, and Microaggressions. CONCLUSION The narratives provide relatable examples of gender discrimination and sexual harassment in radiology. These may spark discussions that raise awareness among radiologists and result in interventions geared toward improvement.
Collapse
Affiliation(s)
- Marika A Pitot
- Mayo Clinic School of Graduate Medical Education, Rochester, Minnesota
| | - Marney A White
- Director, Online Education Social and Behavioral Sciences Track; and Director, Essential Topics in Public Health, Yale School of Public Health, New Haven, Connecticut
| | | | - Monique A Mogensen
- Neuroradiology Fellowship Program Director and Co-Chair, Radiation Safety Subcommittee, Quality and Safety Committee, University of Washington and University of Washington Medical Center, Seattle, Washington
| | | | - Taj Kattapuram
- RadKatt, La Crosse, Wisconsin; ACR, Council Steering Committee; and Wisconsin Rad Society, Board Director-at-Large
| | - Cynthia Sinha
- Aflac Cancer and Blood Disorders, Children's Healthcare of Atlanta, Aflac Cancer and Blood Disorders Center, Atlanta, Georgia; Department of Pediatric Hematology-Oncology-BMT, Emory University, Children's Healthcare of Atlanta, Atlanta, Georgia; and Editorial Board Member, Journal of Marriage and Family
| | - Nadja Kadom
- Director for Quality, Department of Radiology, Children's Healthcare of Atlanta, Atlanta, Georgia; Director for Quality Education, Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia; and Associate Professor, Emory University Hospital, Atlanta, Georgia.
| |
Collapse
|